Provider Demographics
NPI:1346837978
Name:BROWN, STEPHANIE SARRION (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:SARRION
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:SARRION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:39 BLUE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2808
Mailing Address - Country:US
Mailing Address - Phone:860-778-9161
Mailing Address - Fax:
Practice Address - Street 1:843 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-6041
Practice Address - Country:US
Practice Address - Phone:860-778-9161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4634104100000X
CT113161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker